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[Immune-mediated necrotizing myopathy associated with antibodies to hydroxy-methyl-glutaryl-coenzyme A reductase].
Rev Med Interne. 2014 Aug; 35(8):546-9.RM

Abstract

INTRODUCTION

Statins or 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (HMGCR) are among the most commonly prescribed treatment in France. They may be responsible for muscular intolerance with variable severity. They have been recently involved in the occurrence of an acquired inflammatory myopathy associated with anti-HMGCR antibodies. This new type of toxic myopathy remains poorly known by clinicians.

OBSERVATION

We report a 61-year-old woman treated with a statin for many years who developed a lower and upper limb disabling myopathy with a rapid unfavourable course despite treatment withdrawal. Clinical history and investigations, especially including an assay for anti-HMGCR antibodies led to the diagnosis of autoimmune necrotizing myopathy with anti-HMGCR antibodies. Subsequent initiation of an immunosuppressive treatment by corticosteroids and methotrexate was effective.

CONCLUSION

Statins may unmask or cause an autoimmune necrotizing myopathy associated with the presence of anti-HMGCR antibodies. Their identification is now routinely available. An immunosuppressive treatment is necessary and justified by the autoimmune nature of the disease.

Authors+Show Affiliations

Service de médecine interne-soins continus, centre hospitalier Emile-Muller, 20, rue du Dr-René-Laennec, 68070 Mulhouse, France. Electronic address: hinschbergero@ch-mulhouse.fr.Laboratoire de microbiologie, centre hospitalier Emile-Muller, 20, rue du Dr-René-Laennec, 68070 Mulhouse, France.Service de pathologie, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg cedex, France.Service de médecine interne-soins continus, centre hospitalier Emile-Muller, 20, rue du Dr-René-Laennec, 68070 Mulhouse, France.Service de médecine interne-soins continus, centre hospitalier Emile-Muller, 20, rue du Dr-René-Laennec, 68070 Mulhouse, France.Service de médecine interne-soins continus, centre hospitalier Emile-Muller, 20, rue du Dr-René-Laennec, 68070 Mulhouse, France.Service de médecine interne-soins continus, centre hospitalier Emile-Muller, 20, rue du Dr-René-Laennec, 68070 Mulhouse, France.Service de médecine interne-soins continus, centre hospitalier Emile-Muller, 20, rue du Dr-René-Laennec, 68070 Mulhouse, France.

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

fre

PubMed ID

23910221

Citation

Hinschberger, O, et al. "[Immune-mediated Necrotizing Myopathy Associated With Antibodies to Hydroxy-methyl-glutaryl-coenzyme a Reductase]." La Revue De Medecine Interne, vol. 35, no. 8, 2014, pp. 546-9.
Hinschberger O, Lohmann C, Lannes B, et al. [Immune-mediated necrotizing myopathy associated with antibodies to hydroxy-methyl-glutaryl-coenzyme A reductase]. Rev Med Interne. 2014;35(8):546-9.
Hinschberger, O., Lohmann, C., Lannes, B., Martzolff, L., Vo, B. D., Jaeger-Bizet, F., Ciobanu, E., & Kieffer, P. (2014). [Immune-mediated necrotizing myopathy associated with antibodies to hydroxy-methyl-glutaryl-coenzyme A reductase]. La Revue De Medecine Interne, 35(8), 546-9. https://doi.org/10.1016/j.revmed.2013.06.009
Hinschberger O, et al. [Immune-mediated Necrotizing Myopathy Associated With Antibodies to Hydroxy-methyl-glutaryl-coenzyme a Reductase]. Rev Med Interne. 2014;35(8):546-9. PubMed PMID: 23910221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Immune-mediated necrotizing myopathy associated with antibodies to hydroxy-methyl-glutaryl-coenzyme A reductase]. AU - Hinschberger,O, AU - Lohmann,C, AU - Lannes,B, AU - Martzolff,L, AU - Vo,B D, AU - Jaeger-Bizet,F, AU - Ciobanu,E, AU - Kieffer,P, Y1 - 2013/07/30/ PY - 2012/10/15/received PY - 2013/05/02/revised PY - 2013/06/23/accepted PY - 2013/8/6/entrez PY - 2013/8/6/pubmed PY - 2015/5/12/medline KW - Anti-3-hydroxy-3-methyl-glutaryl-coenzyme A reductase antibodies KW - Anticorps anti-3-hydroxy-3-méthyl-glutaryl-coenzyme A réductase KW - Myopathie nécrosante KW - Myotoxicity KW - Necrotizing myopathy KW - Statines KW - Statins KW - Toxicité musculaire SP - 546 EP - 9 JF - La Revue de medecine interne JO - Rev Med Interne VL - 35 IS - 8 N2 - INTRODUCTION: Statins or 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (HMGCR) are among the most commonly prescribed treatment in France. They may be responsible for muscular intolerance with variable severity. They have been recently involved in the occurrence of an acquired inflammatory myopathy associated with anti-HMGCR antibodies. This new type of toxic myopathy remains poorly known by clinicians. OBSERVATION: We report a 61-year-old woman treated with a statin for many years who developed a lower and upper limb disabling myopathy with a rapid unfavourable course despite treatment withdrawal. Clinical history and investigations, especially including an assay for anti-HMGCR antibodies led to the diagnosis of autoimmune necrotizing myopathy with anti-HMGCR antibodies. Subsequent initiation of an immunosuppressive treatment by corticosteroids and methotrexate was effective. CONCLUSION: Statins may unmask or cause an autoimmune necrotizing myopathy associated with the presence of anti-HMGCR antibodies. Their identification is now routinely available. An immunosuppressive treatment is necessary and justified by the autoimmune nature of the disease. SN - 1768-3122 UR - https://www.unboundmedicine.com/medline/citation/23910221/[Immune_mediated_necrotizing_myopathy_associated_with_antibodies_to_hydroxy_methyl_glutaryl_coenzyme_A_reductase]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0248-8663(13)00566-3 DB - PRIME DP - Unbound Medicine ER -